Summary of policy aims and desired outcomes
Following First Ministers’ statement of 14 December 2021 Coronavirus (COVID-19) update: First Minister's statement – 14 December 2021 - gov.scot (www.gov.scot) a package of measures have been reintroduced to strengthen the public health response to the new VoC Omicron. The First Minister also stated the commitment to keep Schools open and for Early Learning and Childcare Settings to be prioritised. The evidence for this is summarised here Coronavirus (COVID 19): Advisory Sub-Group on Education and Children’s Issues minutes: 14 December 2021 - gov.scot (www.gov.scot).
The priority is:
- To suppress transmission
- Protect those most vulnerable to infection
- Create time and space for vaccine roll out
This new variant is significantly more transmissible than the previous dominant strain (Delta), putting pressure on the health service and public services through self-isolation requirements, even if this strain does not lead to more severe illness.
The success of the vaccination programme means that a significant majority of the adult population is now fully or partially vaccinated. However, for younger age groups, the MHRA has approved vaccinations for 12+, and more recently for 5-11’s. The JCVI has recommended two dosages for children 12+ and this is currently being rolled out. However, for 5-11 yr olds, it is only those who are clinically vulnerable or live in households where someone is immunosuppressed, who will be prioritised for vaccination in the coming weeks. This may change over time.
As part of the package of measures, Vaccine Certification or Testing is now in place to enable accessibility to a ‘wide range’ of leisure pursuits that form part of societal life. As part of Vaccine Certification and Testing legislation and policy, a CRWIA was carried out and published on 29 Nov 21 here
The CRWIA for that scheme’s overarching aims were as follows:
- Reduce the risk of transmission of Coronavirus
- Reduce the risk of serious illness and death thereby alleviating current and future pressure on the National Health Service
- Reduce the risk of settings specified in the scheme being required to operate under more restrictive protections, or to close; and
- Increase the protection enjoyed by those using settings covered by the scheme and their contacts.
Policy decisions were taken at that time to exempt children and young people, under 18, from that scheme. The impact assessment of not including children are fully set out in that CRWIA, and include some sub population groups who may be disproportionately affected by this position:
- Care experienced children
- Disabled children
- LGBT children
- ME children
- Young carers
- Children from low-income families
These decisions are now connected to the current state of the pandemic and the new Covid-19 variant (Omicron) which has significantly higher rates of transmissibility and more potential for immune-escape. This culminates in, using the most recent modelling, a significant risk of a higher proportion of the population who could get infected, leading to, without any other factors changing, a higher number of the population who could end up in hospital/severely unwell. We do not yet fully know the potential impact on severity of this version of the disease at a population level, including for children and young people.
It is likely that the population who are unvaccinated, either by choice or because they are unable to do so (as is currently the case for the majority of children under 12), will be more likely to transmit the disease. However, we do not yet know whether this will be true for children and young people, in the same way as it might be for adults. The risks to health in the overall population (Harm 1) through this increased transmission and to the NHS quickly becoming overwhelmed are now exponentially higher. The overall health risk to children in becoming severely unwell from Covid-19 infection remains very low. However, the wider health and social harms (Harm 3) for children and young people that have already occurred, and continue to impact, are increasing.
The risk of higher transmission through the unvaccinated population, particularly for those who do not have a choice on whether to get vaccinated (under 12s), cannot immediately be fully mitigated through existing public health measures. This means that new measures are required, and a number of children’s rights will be impacted to create a proportionate response to the current threat.
However, we also know that all children have been harmed by actions taken during the pandemic to manage transmission and infection, but some children have come to greater harm and the extent of that harm is still emerging. Preventing children from socialising with their peers, exercising through play, and from being visible to wider family and in the community has caused them harm.
Shifting service provision to largely remotely delivered for large parts of the last 20 months has also caused harm, some of it largely hidden and only becoming visible now. There is no evidence that services designed to provide safeguarding and health promotion, to new parents and young children, can be delivered safely remotely. But there is strong evidence that seeing children and families in their own environment is the best way to assess potential risk, build parenting capacity and support healthy child development. We must learn from the impacts of altering relational service delivery models, without a clear evidence base, and take all the steps we can to:
- Ensure services that provide support to children and families remain fully accessible and can deliver preventive care in an evidence based way;
- Ensure that babies, children and young people are protected from harm, and are supported to thrive in environments that fully meet their needs;
- Ensure restrictive measures, designed to protect the adult population from health harm, are fully weighed against causing further harm to the youngest in our society, and act accordingly.
We have detailed where the provisions engage UNCRC Articles.
Article 3: the best interests of the child
Article 6: the right of every child to life and develop to their full potential.
Article 23: the right of a child with a disability to live a full and decent life with dignity and, as far as possible.
Article 24: the right to health and health services
Article 31: the right of every child to relax, play and take part in a wide range of cultural and artistic events.
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